OBJECTIVES: Analysing the course of therapy, resource utilization and costs for treatment of metastatic colorectal cancer (mCRC) in Germany. DATA AND METHODS: The study is based on the Leipziger Gesundheitsforen - a sickness fund dataset of more than 5 million insured persons including pharmaceutical, outpatient and inpatient data from 2007 until 2013. Between 816 (2007) and 1,116 (2013) persons had a first documentation of ICD-10-codes C18-21 (first diagnosis CRC) as well as C77-79 (metastases) and were classified as mCRC patients. Several analyses were performed to identify the most commonly used first-line combination therapies, average treatment durations (Kaplan-Maier-estimation), second-line therapies, therapy switches, resource utilization, best-supportive care and therapy costs. RESULTS: Nearly half of the mCRC patients were treated with only one therapy line, the other half at least with two lines. The most frequently used first-line therapy was the combination of 5-flourouracil, bevacizumab, folinic acid and oxaliplatin for both patient groups (average treatment duration: 192 days). Patients with more than one line were mostly treated second-line with the combination of CONCLUSIONS: This study analysed the course of therapy, resource utilization and costs for the treatment of metastatic colorectal cancer (mCRC) in Germany. The combination of 5-flourouracil, bevacizumab, folinic acid and oxaliplatin was the most often used first-line therapy. For the second-line treatment oxaliplatin was switched to irinotecan. Due to the high resource utilization and the expensive therapies, mCRC is associated with a high economic burden.